Why Addiction & Mental Illness Often Go Hand-In-Hand

In honor of Mental Illness Awareness Week – October 5^th – 11^th

In 2021, nearly 19.4 million people age 12 and older had both a substance use disorder (SUD) and mental health condition, as reported by Columbia University’s Department of Psychiatry. Living with a both SUD and mental illness, often referred to as ‘co-occurring disorders,’ can make recovery and treatment much more complex and challenging. The patients we treat have a much better chance of success in recovery if we address both conditions with equal importance.

“When we meet someone struggling with addiction, we know mental health is often part of the story,” says Dr. Deana Kimes, BrightView’s Medical Director. “Treating both conditions together isn’t optional — it’s essential. Integrated care helps patients feel understood and gives them the best chance for lasting recovery.”

Understanding the Link Between Addiction and Mental Health

Individuals with untreated mental illness have a higher chance of developing a SUD largely because many turn to substance use for relief rather than seeking treatment. In fact, in 2021 only 6% of individuals with co-occurring mental illness and SUD received integrated care, according to Columbia University’s Department of Psychiatry.

These individuals may use illicit substances to self-medicate or cope with their symptoms due to:

• Limited access to healthcare
• Stigma
• Cost barriers
• Few support systems
• Limited education and treatment
• Unhealthy coping skills

According to the National Institute of Mental Health (NIMH), some mental illnesses alter the brain in ways that can make substances feel more rewarding. In search of that feeling, individuals will continue taking the substance increasingly, furthering their chance of developing a SUD.

SUD changes brain chemistry and function. Therefore, substance use that precedes the first signs of mental illness can jumpstart the development of a mental health disorder because some of the same areas of the brain are disrupted by both drug use and mental illness. It also worsens already existing conditions by elevating symptoms.

Factors That Influence Both Mental Illness and SUD

Based on research from the National Library of Medicine (NLM), there are several overlapping factors that can contribute to mental illness and SUD.

1. Genetics: It is estimated that 40-60% of an individual’s vulnerability to substance use disorders is attributed to genetics. Amongst many, genes that influence the action of neurotransmitters affected by drug use and dysregulated mental illness, such as dopamine and serotonin, highly impact risk for a SUD or mental illness.
2. Epigenetics: Epigenetics is the study of changes in the regulation of gene activity and expression that are not dependent on gene sequence. Factors such as stress, trauma, or drug exposure can induce changes in gene expression, altering neural circuits and impacting behavior.
3. Brain Chemistry: Circuits in the brains that mediate reward, decision-making, impulse control, and emotions may be affected by addictive substances and disrupted in mental health disorders.
4. Environmental Influences: Chronic stress, trauma, and adverse childhood experiences increase risk of SUD and mental illness. Prevention interventions often result in reductions in both conditions.
5. Stress: Chronic stress is a major risk factor for relapse in SUD and in developing mental illness. Being exposed to high levels of stress impacts feelings of motivation, ability to learn, and behavioral control – leading to increased impulsivity.
6. Trauma and Adverse Childhood Experience: Based on data from the National Institute on Drug Abuse, over 30% of adults with SUD had childhood trauma including emotional abuse, sexual abuse, emotional neglect, or physical neglect. People with trauma, emotional or physical, are at much higher risk for SUD and co-occurring mental illness. They are more likely to use substances to cope with anxiety and negative memories.

Why Is It Important to Treat These Co-Occurring Disorders?

According to NLM, the brain of a person with mental illness goes through changes that may increase vulnerability for problematic drug use. Using substances may alleviate symptoms of a person’s mental illness, which often drives them to continue and causes them to lose awareness of the negative effects it causes.

The good news is treatment works when both problems are addressed together. With the comorbidity rates of mental illness and SUD being so high, it is critical to treat both conditions with care and precision. We can treat mental illness and SUD by utilizing:

1. Integrated Care: combines both SUD and mental health treatment using medication, therapies, case management, or a combination.
2. Counseling & Therapy: helps patients learn more about themselves, build healthy coping skills, and heal from trauma.
3. Family Based Intervention: tools like functional family therapy help families to improve relationship dynamics, communication, and the home environment.
4. Medication: can effectively treat and lessen symptoms of both SUD and mental illness.

There Is Hope

Fighting both SUD and mental illness can feel like a never-ending internal battle, but there is hope. With continuing awareness and better understanding of mental health issues, we are seeing an increase in resources and conversations about accessible treatment. To learn more about how you can find mental health services near you, check out NIHM’s resource guide to finding treatment in your area.

At BrightView, we understand that addressing mental and behavioral health disorders is critical in treating SUD. BrightView specializes in treating individuals with both SUD and a mental health condition. We help patients manage their mental illness through group therapy and counseling. Reach out today – you don’t have to fight this alone. Visit our website at brightviewhealth.com to learn more.

Sources

Cantor, C. (2023, September 27). Substance Use Disorder and Mental Illness Often Go Hand in Hand. Both Must Be Addressed. Columbia University Department of Psychiatry. http://columbiapsychiatry.org/news/mental-health-and-substance-use-disorders-often-go-hand-hand-both-must-be-addressed

National Institute on Drug Abuse (US). (2020, April). Common Comorbidities with Substance Use Disorders Research Report. National Center for Biotechnology Information: U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK571451/

National Institute of Mental Health. (2025a, March). Finding Help For Co-Occurring Substance Use and Mental Disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health#:~:text=Mental%20disorders%20can%20lead%20to,risk%20of%20substance%20use%20disorders. component of the U.S. Department of Health and Human Services.

Wang, J.-C., Kapoor, M., & Goate, A. M. (2012, June 11). Annual Review of Genomics and Human Genetics: The Genetics of Substance Dependence. PubMed Central . https://pmc.ncbi.nlm.nih.gov/articles/PMC3474605/

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